This article reports the conclusions of a consensus expert conference on the basic principles and nomenclature of renal replacement therapy (RRT) currently utilized to manage acute kidney injury (AKI). This multidisciplinary consensus conference discusses common definitions, components, techniques, and operations of the machines and platforms used to deliver extracorporeal therapies, utilizing a “machine-centric” rather than a “patient-centric” approach. We provide a detailed description of the performance characteristics of membranes, filters, transmembrane transport of solutes and fluid, flows, and methods of measurement of delivered treatment, focusing on continuous renal replacement therapies (CRRT) which are utilized in the management of critically ill patients with AKI. This is a consensus report on nomenclature harmonization for principles of extracorporeal renal replacement therapies. Devices and operations are classified and defined in detail to serve as guidelines for future use of terminology in papers and research.

/pdf/nomenclature-for-renal-replacement-therapy-in-acute-kidney-57jt88r0wr.pdf

Nomenclature for renal replacement therapy in acute kidney injury: basic principles

ABO incompatible kidney transplantation (ABOi-KT) was previously considered to be an absolute contraindication for patients with end-stage kidney disease (ESKD) due to hyperacute rejection related to blood type barrier. Since the first successful series of ABOi-KT was reported, ABOi-KT is performed increasingly all over the world. ABOi-KT has led to an expanded donor pool and reduced the number of patients with ESKD awaiting deceased kidney transplantation (KT). Intensified immunosuppression and immunological understanding has helped to shape current desensitization protocols. Consequently, in recent years, ABOi-KT outcome is comparable to ABO compatible KT (ABOc-KT). However, many questions still remain unanswered. In ABOi-KT, there is an additional residual immunological risk that may lead to allograft damage, despite using current diverse but usually intensified immunosuppressive protocols at the expense of increasing risk of infection and possibly malignancy. Notably, in ABOi-KT, desensitization and antibody reduction therapies have increased the cost of KT. Reassuringly, there has been an evolution in ABOi-KT leading to a simplification of protocols over the last decade. This review provides an overview of the history, outcome, protocol, advantages and disadvantages in ABOi-KT, and focuses on whether ABOi-KT should be recommended as a therapeutic option of KT in the future.

ABO incompatible renal transplants: Good or bad?

Triamcinolone acetonide-loaded PLA/PEG-PDL microparticles for effective intra-articular delivery: synthesis, optimization, in vitro and in vivo evaluation

Double filtration plasmapheresis in the treatment of pancreatitis due to severe hypertriglyceridemia

Mercury poisoning through intravenous administration: Two case reports with literature review.

We investigated whether the presence/absence of vasodilation in cases of shunt stenosis affected flow volume (FV) and resistance index (RI) values, as well as outcomes and vascular access (VA) prognosis. The subjects were 96 patients who underwent ultrasound(cid:514)guided vascular access intervention therapy (VAIVT). They had stenotic cross(cid:514)sectional areas of ≤ 3.14 mm 2 in a non(cid:514)vasodilated state. They were divided into a poor vasodilation and good vasodilation groups, and the cross(cid:514)sectional area, FV, RI, and maximal diastolic pressure without avascularization before VAIVT were compared. The results suggested that the effects of treatment were weaker in the good vasodilation group than in the poor vasodilation group, in which some subjects showed significant stenosis in the non(cid:514)vasodilated state. If blood vessel cross(cid:514)sectional

/pdf/influence-of-differences-in-vasodilatory-capacity-in-shunt-3ror5w3p.pdf

Influence of differences in vasodilatory capacity in shunt stenosis on treatment results and inspection standards

脳血流の指標とされる前頭葉混合血酸素飽和度（FL‒rSO2）を，透析中に測定した血圧低下症例を3例報告する．症例1は76歳男性，オンライン血液透析濾過を施行した患者であり，開始2時間後より2度の急激な血圧低下とともにFL‒rSO2の低下が認められた．症例2は65歳女性，15分毎に50 mLの補液を行う間歇補充型血液透析濾過（少量頻回補液IHDF）を施行した患者であった．透析開始時より血圧とブラッドボリューム（BV）は低値で推移したが，FL‒rSO2は安定して推移した．症例3は68歳女性，少量頻回補液IHDFを施行した患者であり，BV低下はわずかであったが，開始3時間後より血圧低下を認め，FL‒rSO2はIHDFの補液に反応して変化した．脳血流の調節メカニズムは複雑であり，血圧やBVで管理することは難しいが，透析中のFL‒rSO2モニタリングは脳循環管理の指標として有用である可能性がある． 

Changes in frontal lobe regional oxygen saturation in cases of intradialytic hypotension

Therapeutic plasmapheresis has been used for intractable diseases that cannot be cured by conventional drug therapy. Currently, the use of therapeutic plasmapheresis has been approved for 27 diseases by Japan's National Health Insurance system and is mainly categorized into three modalities: plasma exchange (PE), double-filtration plasmapheresis (DFPP), and plasma adsorption (PA). Plasma separators and/or fractionators are essential for the therapy. PE is performed for two purposes: removal of pathogenic antigens or substances in the plasma fraction and supplementation of essential factors, such as albumin and coagulation factors. PE can be used for thrombotic microangiopathy and acute hepatic failure. DFPP can be performed for selective removal of macromolecules while avoiding the use of substitution fluid (i.e., albumin or fresh frozen plasma). DFPP has now been used for conditions involving relatively larger plasma molecules, including hyperviscosity syndrome and ABO-incompatible kidney transplantation. PA can specifically remove pathogenic agents, such as low-density lipoprotein or autoantibodies, in the IgG fractions by the adsorption column and does not require substitution fluids. PA has now been used for a wide variety of neurological diseases, including chronic inflammatory demyelinating polyneuropathy. This review describes the characteristics of each modality, seeking to improve the efficacy and specificity of removal of the target substance.

Current topics in therapeutic plasmapheresis

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Influence of differences in vasodilatory capacity in shunt stenosis on treatment results and inspection standards

Changes in frontal lobe regional oxygen saturation in cases of intradialytic hypotension

Current topics in therapeutic plasmapheresis